根据下面资料，回答题 Why Depression Needs a New Definition [A] Many psyc-考呗网题库移动版

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Why Depression Needs a New Definition
[A] Many psychiatrists believe that a new approach to diagnosing and treating depression--linkingindividual symptoms to their underlying mechanisms--is needed for research to move forward．Inhis Aphorisms, Hippocrates defmed melancholia (抑郁症), an early understanding of depression,as a state of "fears and losing courage, if they last a long time．" It was caused, he believed, by anexcess of bile (胆汁) in the body (the word "melancholia" is ancient Greek for "black bile").
[B] Ever since then, doctors have struggled to create a more precise and accurate definition of the illness that still isn't well understood．In the 1920s, the German psychiatrist Kurt Schneider arguedthat depression could be divided into two separate conditions, each requiring a different form oftreatment: depression that resulted from changes in mood, which he called "inner depression",and depression resulting from reactions to outside events, or "reactive depression"．His theorywas challenged in 1926, when the British psychologist Edward Mapother argued in the BritishMedical Journal that there was no evidence for two distinct types of depression, and that theapparent differences between depression patients were just differences in the severity of thecondition.
[C] Today, Schneider's subtypes have largely fallen out of favor, but over the years, many moredefinitions were offered in their place．In 1969, the American psychologist Rollo May wrote in hisbook Love and Will that "depression is the inability to construct a future," while the cognitivepsychologist Albert Ellis argued in 1987 that depression, unlike "appropriate sadness", stemmedfrom "irrational beliefs" that left sufferers ill-equipped to deal with even mild setbacks.
[D] In 1952, the American Psychiatric Association tried to standardize the definitions of mentalillnesses, including depression, by creating a taxonomy (分类法) of mental illnesses．In the fLrstedition of the Diagnostic and Statistical Manual, depression was listed under the broad categoryof "disorders without clearly def'med physical cause"．The DSM-III, published in 1980, was theAPA's first attempt to clarify the definitions of specific disorders by listing their symptoms; the newedition included guidelines for differentiating depression from other disorders, and outlined eightsymptoms of depression, included "poor appetite or significant 'weight loss" and "complaints orevidence of diminished ability to think or concentrate"．If an adult met four of the eight symptoms,the manual counseled, he or she would meet the criteria for clinical depression．In the DSM-V,published in 2013, depressive disorders were fmally allocated their own chapter．The diagnosticcriteria were mostly unchanged, with the exception of one additional symptom : "Depressed moodmost of the day, nearly every day, as indicated by either subjective report ( e．g．, feels sad orempty) or observation made by others (e．g．, appears tearful)."
[E] Some scientists believe that the DSM-V definition is still too vague．As the psychiatrist Daniel Goldberg noted in the journal World Psychiatry in 2011, many of the DSM symptoms are opposites, which can make it difficult for researchers working to develop a more preciseunderstanding of the condition．"A patient who has psychomotor retardation ( 精神运动性阻痴 ),hypersomnia ( 嗜睡 ), and gaining weight is scored as having identical symptoms as another who isagitated, sleeping badly, and has weight loss," Goldberg wrote.
[F] Many recent studies have verified Goldberg's concerns．In 2000, for example, a group of researchers at Johns Hopkins Univemity attempted to identify subtypes of depression by studying the symptoms of nearly 2,000 patients．However, the researchers were unable to find much of a pattern connecting gender, family history, symptoms, and the degree of the condition ( mild to severe)．"Depression is of different kind," they concluded, adding that "the severity of an episode appears to be more informative than the pattern of symptoms．" And in 2010, researchers in Germany testing the validity of the DSM-IV definition found that the criteria captured a huge population of patients with "widelyvarying associations with the pattern of co-morbidity ( 共病 ), personality traits, features of the depressive episode and demographic characteristics．" The results, they argued, " challenge our understanding of major depression as a similar categorical entity．"
[G] Part of the problem, said Scott Monroe, a professor of psychology at the University of Notre Dame, is that in medical term, depression is considered a syndrome rather than a disease．While a disease is a specifi, c condition characterized by a common underlying cause and consistent physical traits, a syndrome is a collection of signs and symptoms known to frequently appear together, but without a single known cause．In a paper published in June in the journal Current Directions in PsychologicalScience, Monroe called for scientists to begin defining depression with more precision．"It is in thisvague and imprecise realm that problems can arise," he wrote, "and vague insights based on imperfect similarities and differences eventually may prove to be clear oversights．"
[ H ] Part of the reason that scientists are still working in the "vague and imprecise realm", as Monroe put it, is because they still don't have a clear answer for what cat ses depression．In the 1960s, the dominant hypothesis was that it stemmed from a chemical imbalance in the brain, specifically from lower levels of the neurotransmitter serotonin ( 血清素 )．As a result, drug companies poured resources into developing "selective serotonin reuptake inhibitors" (SSRIs), drugs that increased the amount of serotonin in the brain．SSRIs are still the most commonly prescribed type of antidepressant--despite the fact that research has shown that lower levels of serotonin do not necessarily cause depression for all individuals．And in 2010, a review of three decades' worth of studies on antidepressants found that while SSRIs can be helpful for severely depressed people, their effectiveness "may be minimal or nonexistent" in those with mild or moderate depression.
[I] Bruce Cuthbert, the director of adult translational (平动 ) research and treatment development at the National Institute of Mental Health ( NIMH), thinks that part of the problem is that researchers have largely focused their attention on fmding a one-size-fits-all treatment that doesn't exist．"When you do a clinical trial, you're getting a bunch of people who are ' depressed', but they're actually very different," he said．"It's like comparing apples, pears, and oranges．You're not going to see a significant effect．You're not going to be able to say, ' This treatment works for fruits．' " Trying to create a singular treatment for depression, Cuthbert said, is like trying to create one for cancer: too unspecific to actually be helpful．"Our current diagnostic system is running out of steam for research．" "While DSM has been described as a ' Bible' for the field, it is, at best, a dictionary, creating a set of labels and defining each," the NIMH director Tom Insel wrote in 2013.
[J] In 2010, Insel invited Cuthbert, who was then working as a psychology professor at the University of Minnesota, to help the NIMH develop a new framework for defining mental illness．The result, unveiled in 2013, was the Research Domain Criteria ( RDoC ), a system created to flip the way researchers think about mental disorders．Unlike the DSM, RDoC isn't organized by disorder; instead, it's organized around specific symptoms, like fear, anhedonia (the inability to feel pleasure), and willingness or unwillingness to work．The system also lists the genes, neural circuits, physical response, and self-reported behavior associated with each symptom.
[K] The theory behind this RDoC system is that treating a specific symptom will produce better results than treating a broad category of illness．Many depression patients exhibit anhedonia, for example, but many others don't．But if researchers took a group of patients who all displayed anhedonia, regardless of their diagnosis ( it's also a common symptom of schizophreniA．and tested treatments for that very specific symptom, they would get better results for treating anhedonia.
[L] The current definition of depression, Cuthbert explains, has largely stemmed from scientists observing patients and then developing lists of symptoms based on what they saw．"The belief was that if you described the disorder well enough, you would be able to define it," he said．But it's becoming increasingly clear, he said, that by relying on describing the disorder, scientists are only skimming the surface in terms of understanding it．Cuthbert hopes that the RDoC system will challenge researchers to look at the mechanics of each symptom more closely, and in the process, come up with more well-informed ideas around how to diagnose mental illness．"We're starting over with how we think about mental disorders," Cuthbert said．"Our current diagnostic system is ranning out of steam for research．" "Our current concept of depression is left over from times when we didn't really understand it very much," he added．"We know so much more about it now--physically, genetically, neurochemically--and we should be using that．"
A particular psychiatrist believed that there were two distinct types of depression which should be treated differently.

参考答案B

解析:分析

本文主要阐	[A]一[B]段介绍了最早希波克拉底和施耐德对抑郁症的定义。
述了对抑郁症进行更加	[C]一[D]段指出多年以来出现了很多新的定义，如罗洛·梅、阿尔伯特·爱丽丝对抑郁症的定义，并且特别指出了美国心理学会在《诊断与统计手册》中对抑郁症的定义及其五个不同的版本。
明确和精准定义的必要性．同时介绍	[E]一[F]段指出一些科学家(譬如丹尼尔·戈德伯格)认为《诊断与统计手册第五版》的定义还是太模糊了，而且也有很多研究证实了戈德伯格的看法，同时指出抑郁症并不像传统观点认为的那样具有共性，是同质范畴类的疾病。
了对抑郁症进行定义的	[G]一[I]段分析抑郁症不具有共性的原因，以及科学家还不能找出治疗抑郁症方法的原因。
发展历史：	[J]一[L]段提出治疗抑郁症的新视角，即RDoC(研究领域标准)，及其背后的理论。

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